TRANSPORT INTRACYTOPLASMIC SPERM INJECTION (ICSI) - A COST-EFFECTIVE ALTERNATIVE

Purpose: Transport in vitro fertilization (IVF) programs are operation al in a lot of countries and especially popular in The Netherlands, wh ere IVF activities are strictly regulated. Since the introduction of i ntracytoplasmic sperm injection (ICSI) in the IVF laboratory many labo ratories are now setting lip this new technique, which necessitates ma jor investments in terms of infrastructure and specialized personnel. Methods: We present a cost effective alternative, consisting of patien t selection, preparation, and oocyte retrieval at one center and trans port of oocytes to a second center; where the ICSI procedure and embry o transfer are performed, Since early 1994 several Dutch centers have a transport ICSI program running with the Gent University Infertility Gentes and we wish to present the results of our cooperation with two major centers, comparing them to our local results, for the first 10 m onths of 1994. Patient selection was similar at all three centers: onl y couples with previously failed in vitro fertilization or having been refused for routine IVF were enrolled in the program. Stimulation sch emes and follow-up of the stimulation were different at all three cent ers, Transport of oocytes was carried out in a transport box or by att aching the closed tubes containing the follicular aspirates to the che st of the husband Transport times varied between 1.5 and 3 hr; dependi ng on traffic conditions. Results: Up to November 1, 1994, a total of 77 transport ICSI cycles and 294 own ICSI cycles were carried out. Alt hough locally significantly more oocytes were retrieved and thus avail able for ICSI than in transport cycles, fertilization and pregnancy ra tes were not different between the two groups. Conclusions: These resu lts suggest that long-distance transport of human oocytes seems not to be harmful to their capacity to be successfully injected and to furth er embryonic development and their implantation potential. Transport I CSI seems to be a valuable and cost-effective approach to treat high n umbers of patients at a restricted number of highly specialized IVF la boratories, especially in countries where ICSI is not commonly availab le.